Iqbal M, Patel I K, Shah S H, Ain Q, Barney N, Kiani Q, Rabbani K Z, Zaidi G, Mehdi B
Department of Medicine, Shifa College of Medicine and International Hospital, Islamabad.
J Pak Med Assoc. 2002 Sep;52(9):407-11.
To study Escherichia coli (E. coli) susceptibility, prevalence of multidrug-resistant isolates and possible role of extended spectrum beta-lactamases (ESBL) in E. coli resistance.
Department of Medicine, Shifa College of Medicine, Islamabad.
Three hundred and seventy eight E. coli isolates from different sources were identified during six-month period. Susceptibility to various antibiotics was checked using standard methods. Multidrug-resistant isolates were separated. Isolates resistant to cefpodoxime and aztreonam were considered as ESBL phenotype, indicating ESBL production.
Most of isolates were resistant to ampicillin and trimethoprim/sulfamethoxazole. Overall resistance to ciprofloxacin, ceftriaxone, cefotaxime and cefpodoxime was 49%, 34%, 36% and 38% respectively. Resistance to fourth generation cephalosporins was lower. Almost all Isolates were sensitive to amikacin, imipenem and tazobactam. Aztreonam resistance was found in 25% isolates. Similar pattern was observed for urinary E. coli isolates; 45% E. coli isolates were found to be multidrug-resistant. Nitrofurantoin showed low-level resistance both to multidrug-resistant as well as urinary isolates. Resistance to both cefpodoxime and aztreonam was found in 25% isolates suggesting ESBL production.
E. coli resistance in Pakistan is much higher than reported from western literature. Multidrug-resistant isolates, including third generation cephalosporins and quinolones, are very common. ESBL production may contribute to this high level resistance against beta-lactams.
研究大肠杆菌（E. coli）的药敏性、多重耐药菌株的流行情况以及超广谱β-内酰胺酶（ESBL）在大肠杆菌耐药性中可能发挥的作用。
伊斯兰堡希法医学院医学系。
在六个月期间鉴定了来自不同来源的378株大肠杆菌分离株。使用标准方法检测对各种抗生素的敏感性。分离出多重耐药菌株。对头孢泊肟和氨曲南耐药的分离株被视为ESBL表型，表明产生了ESBL。
大多数分离株对氨苄西林和甲氧苄啶/磺胺甲恶唑耐药。对环丙沙星、头孢曲松、头孢噻肟和头孢泊肟的总体耐药率分别为49%、34%、36%和38%。对第四代头孢菌素的耐药率较低。几乎所有分离株对阿米卡星、亚胺培南和他唑巴坦敏感。25%的分离株对氨曲南耐药。尿源性大肠杆菌分离株呈现类似模式；45%的大肠杆菌分离株被发现为多重耐药。呋喃妥因对多重耐药菌株和尿源性分离株均显示低水平耐药。25%的分离株对头孢泊肟和氨曲南均耐药，提示产生了ESBL。
巴基斯坦的大肠杆菌耐药性远高于西方文献报道。多重耐药菌株，包括第三代头孢菌素和喹诺酮类耐药菌株非常常见。ESBL的产生可能导致了对β-内酰胺类抗生素的高水平耐药。
